Osteoarthritis is estimated to be the most prevalent musculoskeletal disorder in the world. Estimates show that the disease is prevalent in 18% and 10% in women and men that are aged >60 years old. The quality of life of the affected patients can also be significantly impacted due to the associated morbidities and functional loss. Many interventions have been proposed to preserve the joint and enhance the functional outcomes in patients with osteoarthritis. In the present literature review, we have discussed the different orthobiologic therapies for patients with osteoarthritis for joint preservation and subsequent improvement in the functional and pain outcomes. Variable modalities that have been proposed in the literature include Bone Marrow Aspirate Concentrate (BMAC), gene therapy and platelet rich plasma (PRP). All of these modalities were reported with favorable outcomes and minimal complications. PRP has been reported to have a clinical efficacy that is boosed when co-administered with hyaluronic acid. However, it should be noted that the clinical efficacy is limited in the long term, and administration is continuously required. On the other hand, gene therapy is a promising technique that offers maintained favorable outcomes with no adverse events. However, further studies are still needed to indicate the effectiveness and cost-efficacy of this approach.
The treatment of tendinopathy can be challenging for clinicians and might be associated with serious adverse events. However, evidence shows that tendinopathy can significantly impact the professional careers of the affected athletes. The main clinical features of the condition include decreased performance and strength of the affected tendons, swelling, and localized pain. Although tendinopathy might seem a non-critical condition, estimates show that it might be career-ending for many professional athletes, and therefore, reducing their quality of life. In the present literature review, we have discussed the epidemiology, etiology, and pathogenesis of tendinopathy among athletes. Different intrinsic and extrinsic factors were found to contribute to the development of the condition and the impact of various systemic diseases. Evidence also shows that the prevalence of the condition is high among athletes. However, these rates were variable across the different studies in the literature. This is probably owing to various factors, like demographics and the process of detection. The pathogenesis of the condition is also very complicated, and the development of pain has been attributed to the process of angiogenesis and associated ingrowth of nerve fibers.
As a result of the frequent endurance sports that are being practiced nowadays, many techniques have been introduced to this field with favorable outcomes regarding to the management approaches of the different injuries. However, no previous investigations have adequately discussed the pathophysiology of iliotibial band friction syndrome (ITBS) based on recent evidence from the current studies in the literature. In the present investigation, we have discussed the pathophysiology and related classification of iliotibial band friction injuries based on the current studies in the literature. The current evidence about the pathophysiology of the condition is still controversial, although epidemiological investigations indicate that ITBS is becoming a more prevalent condition among runners and other endurance athletes. Furthermore, many factors can attribute to the development of the condition and have been reported to take essential roles in the pathophysiology of the disease. Some of these factors include gender, iliotibial band tightness, rearfoot eversion and weak hip abductors. Further investigations are still needed to completely understand the pathophysiology of the disease to help clinicians aim to achieve better interventions to enhance the outcome of practicing endurance and excessive exercises.
Many etiologies have been reported to account for injuries to the brachial plexus, peripheral nerves and trauma. Additionally, many diseases have also been reported to cause the injury with many different pathophysiologies. For instance, some diseases have been classified as the primary diseases of the peripheral nerves including hereditary neuropathy. In the same context, brachial plexus damage or injury might also result secondary to a systemic disease, leading to a significant peripheral nerve injury as in cases with most metabolic neuropathies, which may result secondary to renal insufficiency, diabetes, amyloidosis and many other diseases. Furthermore, toxic and iatrogenic causes were also reported as potential causes for brachial plexus injuries. However, traumatic events are the most commonly reported, owing to motorcycle accidents, being the most common etiology. Although evidence is now abundant regarding the etiology, further studies are needed to furtherly validate the evidence and for more specification of the etiology and the underlying mechanisms.
Different organs can be affected secondary to sickle cell disease, including the central nervous system, kidneys, gastrointestinal tract, respiratory system, cardiovascular system, bone, and joints. This can lead to increased morbidity and mortality events among the affected patients. Osteoarticular complications represent a severe set of events for patients with sickle cell disease. These complications might include gouty, septic, juvenile, and erosive arthritis, dactylitis, bone infarction, and osteomyelitis. These are the most common complications reported in the literature, and some case reports even reported other types of complications that develop secondary to the previously mentioned ones. Adequate diagnosis might be challenging in some cases. Therefore, clinicians must be crucial in determining the appropriate clinical and radiographic manifestations. Treating these cases is also challenging. Consequently, clinicians should be aware of these complications to enhance the prognosis of the affected patients. Further research is needed for the standardization of the diagnostic and management approaches in these events.
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